title: [Hypoglycemia and diabetes treatment: the return to normal glucose level is not always the best therapeutic strategy].
abstract: Recent clinical trials with type 2 diabetic patients and the quest of normal glyceamic values, have revealed difficulties and limitations. These too normal glyceamic targets corresponding to the physiological standards are associated with very high rate of hypoglycemia and an increase of mortality. A too simplistic view of treatment: "the lowest, the better is in the diabetes" is no longer defensible. The knowledge from complex systems behavior invites us to search targets adapted to a new state of equilibrium due to loss of self-regulation. These targets should not aim the physiological standards but to be adapted to patient's situation. Shared decision-making and consensus are the two pillars of this new strategy supported by the new ADA-EASD guidelines.
authors.affiliation: Service d'endocrinologie, diabétologie et métabolisme, CHUV, Lausanne. juan.ruiz@chuv.ch
authors.forename: J
authors.initials: J
authors.lastname: Ruiz
mesh_terms: D001786:Blood Glucose / Q000032:analysis / Q000502:physiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000503:physiopathology*; D012015:Reference Standards; D059039:Standard of Care
chemical_list: D001786:Blood Glucose